Niveles séricos de vitaminas en pacientes críticos y su relación con el pronóstico.

Objectives: to know the serum levels of vitamins (A, D, E, K, B1, B6 and B12) in critically ill patients, their changes, as well as their impact on mortality in the intensive care unit.

Methods: prospective study. Serum levels of vitamins A, D, E, K, B1, B6 and B12 were measured at baseline, on day 7 and day 14, as well as the differences in them depending on whether or not the patient received PN (supplemented with a multivitamin complex without vitamin K). Multivariate analysis was performed to study factors related to mortality.

Results: 99 patients were analyzed. The median age was 59 years, and 35.4 % (n = 35) were women. Vitamin A, K, and D levels were low on admission; will increase on days 7 and 14, reaching normal values in the first case, but not for K and D. Higher values of NUTRIC score (OR, 1.38; 95 % CI, 1.07-1.77) and vitamin E at income were independently related to a worse and better prognosis, respectively. In patients with PN, vitamin A and E levels rise significantly at 7 and 14 days compared to baseline without significant changes in the rest of the vitamins studied.

Conclusions: upon admission to the ICU, the levels of vitamins A, D and K were decreased but those of vitamins B1, B6, B12 and E were normal. Parenteral nutrition with vitamin supplementation, but without vitamin K, maintains adequate serum vitamin K levels. We have only identified as a factor associated with prognosis that basal vitamin E level is a protective factor for mortality.